The European Union One Health 2022 Zoonoses Report

Abstract This report by the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of the zoonoses monitoring and surveillance activities carried out in 2022 in 27 Member States (MSs), the United Kingdom (Northern Ireland) and 11 non‐MSs. Key statistics on zoonoses and zoonotic agents in humans, food, animals and feed are provided and interpreted historically. In 2022, the first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The number of cases of campylobacteriosis and salmonellosis remained stable in comparison with 2021. Nineteen MSs and the United Kingdom (Northern Ireland) achieved all the established targets in poultry populations for the reduction of Salmonella prevalence for the relevant serovars. Salmonella samples from carcases of various animal species, and samples for Campylobacter quantification from broiler carcases, were more frequently positive when performed by the competent authorities than when own checks were conducted. Yersiniosis was the third most reported zoonosis in humans, followed by Shiga toxin‐producing Escherichia coli (STEC) and Listeria monocytogenes infections. L. monocytogenes and West Nile virus infections were the most severe zoonotic diseases, with the most hospitalisations and highest case fatality rates. In 2022, reporting showed an increase of more than 600% compared with 2021 in locally acquired cases of human West Nile virus infection, which is a mosquito‐borne disease. In the EU, the number of reported foodborne outbreaks and cases, hospitalisations and deaths was higher in 2022 than in 2021. The number of deaths from outbreaks was the highest ever reported in the EU in the last 10 years, mainly caused by L. monocytogenes and to a lesser degree by Salmonella. Salmonella and in particular S. Enteritidis remained the most frequently reported causative agent for foodborne outbreaks. Norovirus (and other calicivirus) was the agent associated with the highest number of outbreak human cases. This report also provides updates on brucellosis, Coxiella burnetii (Q fever), echinococcosis, rabies, toxoplasmosis, trichinellosis, infection with Mycobacterium tuberculosis complex (focusing on Mycobacterium bovis and Mycobacterium caprae) and tularaemia.


Main findings and trends in 2022
In 2022, the two most commonly reported zoonoses in humans were the gastrointestinal diseases campylobacteriosis and salmonellosis, with a total of 137,107 and 65,208 human cases, respectively.For campylobacteriosis, a slight absolute reduction of 210 cases could be observed, whereas an increase in the absolute number of cases (+5,039) was recorded for salmonellosis.The observed variations in the absolute number of cases did not influence the rates of confirmed cases per 100,000 inhabitants, which remained the same as those registered in 2021: 43.

PLS: EU One Health Zoonoses Report 2022
Controlling the presence of zoonotic microorganisms in food-producing animals is one of the most effective ways of reducing the burden of human illness.National Salmonella control programmes have been implemented for many years in poultry populations (breeding hens, laying hens, broilers, and breeding and fattening turkeys); these programmes aim to reduce the prevalence of those serovars of Salmonella responsible for the vast majority of human cases.
In 2022, 19 Member States and the United Kingdom (Northern Ireland) reached all the established targets for the reduction of Salmonella prevalence for the relevant serovars in the various poultry populations.
Trends in the prevalence of Salmonella target serovar-positive flocks have been reasonably stable in the EU over recent years for these poultry populations, although a significant increase in the prevalence of Salmonella spp.-positive flocks could be observed in breeding turkeys (3.6% in 2022 vs 1.4% in 2016).
Generally, samples collected by the competent authorities at the slaughterhouse for the detection of Salmonella on carcases of different species were more frequently positive than those reported from own-check controls by the food business operators themselves.
The same finding was observed for broilers and fattening turkeys tested in the context of national Salmonella control programmes at the farm level, as well as for Campylobacter quantification results on broiler carcases at EU-level.
The third most commonly reported zoonosis in humans in 2022 was yersiniosis, a disease caused by Y. enterocolitica (or Y. pseudotuberculosis), which is generally associated with the consumption of undercooked pork or vegetables.Next on the list in terms of the number of reported cases were Shiga toxin-producing Escherichia coli (STEC) infections and listeriosis caused by L. monocytogenes.Both Listeria and STEC may cause severe and even fatal foodborne illnesses, especially in high-risk population subgroups, such as elderly, small children, and immunocompromised persons.Infections by L. monocytogenes and West Nile virus were the most severe zoonoses in 2022, with the highest proportions of both hospitalisations and deaths among reported patients.With regard to L. monocytogenes, data on 'ready-to-eat' (RTE) foods confirm that contamination, when present, remained largely within the designated limits.
2022 was an epidemic year for West Nile virus infection.The number of reported human cases of West Nile virus infection and animal outbreaks increased remarkably in particular in some countries of southern Europe.

Foodborne outbreaks
In 2022, 27 Member States and the United Kingdom (Northern Ireland) reported overall 5,763 foodborne outbreaks (43.9% more than in 2021) and 48,605 human cases (a 49.4% increase compared to 2021).The number of deaths (64) observed in 2022 was one of the highest numbers ever reported to EFSA by the EU in the last ten years.Deaths were mainly caused by L. monocytogenes and to a lesser degree by Salmonella.Salmonella, in particular S. Enteritidis, remained the most frequently reported causative agent in foodborne outbreaks.Norovirus (and other calicivirus) was the agent associated with the highest number of outbreak human cases.
Salmonella in 'eggs and egg products' was the agent/food pair most often involved in strongevidence foodborne outbreaks, according to the data provided by the Member States.However, Clostridium perfringens toxins in 'other or mixed red meat and products thereof' (which includes 'meat from deer (venison) -meat preparation -intended to be eaten cooked', 'meat, mixed meat -meat products -ready-to-eat', 'other or mixed red meat and products thereof') was the agent/food pair causing the highest number of cases in strong-evidence outbreaks reported by the EU Member States.The purpose of the PLS is to enhance transparency and inform interested parties on EFSA's work on the topic using simplified language to present a summary of the main findings.
1 and 15.3 for campylobacteriosis and salmonellosis, respectively.

EU One Health Zoonoses Report 2022 number
of outbreaks linked to the consumption of 'mixed foods' (including several different types of food preparations and processed foods) increased considerably in 2022 compared with previous years.Notably, in 2022 there was a major multi-country outbreak of a monophasic variant of Salmonella Typhimurium linked to chocolate-based products and involving mainly children.Moreover, two considerable outbreaks were caused by Listeria monocytogenes and Streptococcus equi subspecies zooepidemicus owing to the consumption of 'broiler meat (Gallus gallus) and products thereof' and 'cheese made from unpasteurised milk', respectively.Outbreaks involving these two pathogens alone caused the highest number of zoonosis-related deaths in single outbreaks in 2022.This Plain Language Summary (PLS) is a simplified communication of EFSA and ECDC's The European Union One Health 2022 Zoonoses Report.The full scientific report can be found here.• The www.efsa.europa.eu/efsajournalEFSA Journal 2023;21(12):8442 PLS: Reference EFSA (European Food Safety Authority) & ECDC (European Centre for Disease Prevention and Control).(2023).The European Union One Health 2022 Zoonoses Report.EFSA Journal, 21(12), e8442.DOI: https://doi.org/10.2903/j.efsa.2023.8442ISSN: 1831-4732 © European Food Safety Authority and European Centre for Disease Prevention and Control, 2023 Reproduction is authorised provided the source is acknowledged.The EFSA Journal is a publication of the European Food Safety Authority, an agency of the European Union Disclaimer •